Botox for Neuralgia Pain Management?

Question

Is it possible to inject Botox inside the mouth high up near the nose. I have neuralgia above two teeth in the gums near my nose.I get sharp pain in the gums and right up my nose. It is limited to a small area that can be isolated. Local anaesthetic (at the dentist) approx 2 cm above the gums stops the pain instantly.  I have heard Botox can make the pain managable.Is it safe to inject in this area. I am not concerned about cosmetic side effects - only dangerous ones!

Michael A. Persky, MD · Answer

Hi Ana,
There have been ongoing clinical studies regarding the use of Botox in the treatment of Trigeminal Neuralgia.  One such study is by Andrew Blitzer, MD at NYU.
It is hypothosized that BOTOX&reg; can inhibit the neurotransmitters that cause trigeminal neuralgia pain.
"The NYUCD study marks the first time that researchers are comparing BOTOX&reg; against other medications for trigeminal neuralgia pain, said the coinvestigators, Dr. David Sirois, an Associate Professor of Oral and Maxillofacial Pathology, Radiology and Medicine at the NYU College of Dentistry, and Dr. Andrew Blitzer, a Professor of Clinical Otolaryngology at Columbia University College of Physicians and Surgeons. Although BOTOX&reg; proved effective against trigeminal neuralgia pain in one earlier study, that trial had only 13 subjects, and did not include other medications or a placebo, for comparison." 
I am not aware of using Botox for other nerves.
Be well.
Dr. P

Tanveer Janjua, MD · Answer

Not Botox but Kenalog.
It is the nasopalatine nerve that is irritated. You should have a physician give you about 5mg of kenalog in that nerve area and that should resolved the inflammation and thus the pain in 2 days. The effect will last for up to 3 months.
Regards

Keith Denkler, MD · Answer

There are multiple article on the use of Botox fot pain and neuralgia.
Should be OK to try it.
Problem is that the lip muscle lifters are just in the same area.  The Botox may help your pain, but cause a asymmetry in your smile!
Cortisone injection (Kenalog) may be a better place to start!

Theodore Katz, MD, FACS (retired) · Answer

I have honestly never encountered this particular problem and would be hesitant to recommend this off lable use of Botox, although it has been used for neuralgias elsehwere.  Did your dentist take xrays?  Is there any history of trauma to this region?  Are the teeth painful in addition to the gum and nose?  Perhaps a little steroid along with the xylocaine or novocaine may help prolong the effect.

Botox for Neuralgia Pain Management?

Answers (4)

Answer: Botox for Gum/teeth pain ("neuralgia")

Answer: Botox for Gum/teeth pain ("neuralgia")

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Botox for Neuralgia Pain Management?

Answers (4)

Answer: Botox for Gum/teeth pain ("neuralgia")

Answer: Botox for Gum/teeth pain ("neuralgia")

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Everything you need to know about Botox

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